基于Robson十分类法分析大连市部分医院剖宫产指征的分布  

Distribution of cesarean section indications based on Robson ten group classification system in some hospital in Dalian

作　　者：王傲 郭风 柳洁 高洁 WANG Ao;GUO Feng;LIU Jie;GAO Jie(Department of Gynaecology and Obstetrics,Dalian Medical Center for Women and Children,Dalian 116033,Liaoning,China)

机构地区：[1]大连市妇女儿童医疗中心(集团)妇产科,辽宁大连116033

出　　处：《中国现代医生》2023年第29期56-59,62,共5页China Modern Doctor

基　　金：大连市医学科学研究计划项目–医学软科学类项目(2122002)。

摘　　要：目的 基于Robson十分类法分析大连市部分医院剖宫产指征的分布。方法 选取2021年1月至12月大连市8家助产医疗机构收治的17 270例孕产妇(约占大连市2021年全市分娩量的52%),根据Robson十分类进行分类,并分析剖宫产指征。结果 孕产妇总体剖宫产率为42.29%(7304/17 270),基于Robson十分类法分析占比较高者为1组(单胎头位、自然临产、29.35%,5069/17 270)、2A组(单胎头位、初产妇引产临产、16.83%,2908/17 270)、2B组(单胎头位、初产妇临产前剖宫产、16.55%,2858/17270)。剖宫产指征中占比较高者为:瘢痕子宫(29.57%,2160/7304)、臀位(9.06%,662/7304)、无指征剖宫产(8.41%,614/7304)。剖宫产总数较高组为2B组(39.13%,2858/7304),前3名剖宫产指征:无指征剖宫产(17.98%,514/2858)、高龄初产(15.61%,446/2858)、巨大儿(14.59%,417/2858)。5A组(1次剖宫产史组)占剖宫产总数27.60%(2016/7304),首位剖宫产指征:瘢痕子宫(99.12%,1999/2016)。2A组占剖宫产总数的7.86%(574/7304),首位剖宫产指征:产程异常(21.77%,125/574)。结论 基于Robson十分类法,对不同组别产妇剖宫产率及剖宫产指征进行分析,有助于识别降低剖宫产率的目标人群,并做出针对性干预措施。Objective To analyze the distribution of cesarean section indications in some hospitals in Dalian based on Robson ten group classification system.Methods A total of 17 270 pregnant women(about 52% of deliveries in Dalian in 2021) admitted to eight midwifery hospitals were selected as research subjects.They were reclassified based on Robson ten group classification system,and analyzed the indications of cesarean section.Results The overall cesarean section rate was 42.29%(7304/17 270).Based on the Robson ten group classification system,the higher proportions:group 1(singleton pregnancy,cephalic presentation and spontaneous labor.accounted for 29.35%(5069/17 270),group 2A(singleton pregnancy,cephalic presentation and primipara of parturition after induction of labor) accounted for 16.83%(2908/17 270) and group 2B(singleton pregnancy,cephalic presentation and primipara undergoing cesarean section before labor onset) accounted for 16.55%(2858/17 270).Among the indications,the higher proportions were scarred uterus accounted for 29.57%(2160/7304),breech presentation accounted for 9.06%(662/7304),and non-indicative cesarean section accounted for 8.41%(614/7304).The group with a higher cesarean section rate was group 2B with 39.13%(2858/7304).The top three indications of cesarean section:non-indicative cesarean section with 17.98%(514/2858),446 cases(15.61%) of primipara of advanced age with 15.61%(446/2858),and macrosomia with 14.59%(417/2858).Group 5A(an experience of cesarean section) accounted for 27.60%(2016/7304),and the top indication of cesarean section was scarred uterus with 99.12%(1999/2016).Group 2A accounted for 7.86%(574/7304),and the top indication of cesarean section was abnormal labor with 21.77%(125/574).Conclusion Based on Robson ten group classification system,analysis of csearean section rate and cesarean section indications of different groups can help identify the target population for reducing cesarean section rate and make targeted intervention measures.

关 键 词：Robson十分类法 剖宫产率 剖宫产指征 瘢痕子宫 

分 类 号：R174.7[医药卫生—妇幼卫生保健]